Nursing Elites

1. A patient is admitted to the emergency room and is found to have proteinuria, a low serum albumin level, edema, and elevated blood lipids. Which condition do these symptoms typically associate with?

• A. Nephrotic syndrome
• B. Acute kidney injury
• C. Rejection of a kidney transplant
• D. Renal colic

Correct answer: A

Rationale: The correct answer is A: Nephrotic syndrome. Nephrotic syndrome is characterized by proteinuria (excess protein in urine), hypoalbuminemia (low serum albumin), edema (swelling due to fluid buildup), and hyperlipidemia (elevated blood lipids). These symptoms occur as a result of damage to the kidneys' filtering units. Acute kidney injury, rejection of a kidney transplant, and renal colic do not present with the same combination of symptoms as nephrotic syndrome. Acute kidney injury typically presents with a sudden decrease in kidney function, resulting in a build-up of waste products in the blood. Rejection of a kidney transplant may present with fever, pain at the transplant site, and changes in urine output. Renal colic usually presents with intense pain in the lower back or side, related to kidney stones.

2. You are on duty in the medical ward. You were asked to check the narcotics cabinet. You found out that what is on record does not tally with the drugs used. What will you do first?

• A. Write an incident report and refer the matter to the nursing director
• B. Keep your findings to yourself
• C. Report the matter to your supervisor
• D. Find out from the endorsement any patient who might have been given narcotics

Correct answer: C

Rationale: In this situation, the first step should be to report the matter to your supervisor. It is essential to notify the appropriate authority immediately to address the discrepancy in the narcotics cabinet. Choice A is not the first step as reporting to the nursing director should follow after informing the supervisor. Keeping the findings to yourself (Choice B) is not appropriate as it may jeopardize patient safety and is against ethical standards. While finding out which patient received narcotics (Choice D) is important, it is not the immediate action to take in this scenario.

3. Which food items should be avoided by a child with lactose intolerance?

• A. Popcorn, seeds, and any foods containing nuts.
• B. Milk, cheese, ice cream, and puddings.
• C. Wheat, rye, barley, and commercially baked goods.
• D. Eggs, ham, bacon, and canned meats.

Correct answer: B

Rationale: The correct answer is B: Milk, cheese, ice cream, and puddings should be avoided by a child with lactose intolerance because they contain lactose, which the child's body may have difficulty digesting. Option A is incorrect as popcorn, seeds, and foods containing nuts do not typically contain lactose. Option C lists wheat, rye, barley, and commercially baked goods, which are sources of gluten, not lactose. Option D includes eggs, ham, bacon, and canned meats, which are also not sources of lactose. Therefore, B is the most appropriate choice for a child with lactose intolerance.

4. What action should the nurse take first for a client with Listeria food poisoning?

• A. Educate the client on safe food practices.
• B. Start a traceback to identify the source of the outbreak.
• C. Report the case to the county board of health.
• D. Ask the client if they have consumed any unpasteurized products.

Correct answer: D

Rationale: Identifying the source of Listeria is crucial for preventing further cases.

5. A nurse is providing dietary teaching to a client who has a new diagnosis of gastroesophageal reflux disease. Which of the following foods or beverages should the nurse recommend to minimize heartburn?

• A. Orange juice
• B. Decaffeinated coffee
• C. Peppermint
• D. Potatoes

Correct answer: D

Rationale: Potatoes are bland and less likely to relax the lower esophageal sphincter, making them a suitable choice to minimize heartburn in clients with gastroesophageal reflux disease. Orange juice and peppermint are acidic and can exacerbate GERD symptoms, while coffee, even decaffeinated, can stimulate acid production and worsen heartburn.

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